1/19. Humoral hypercalcemia associated with a dysgerminoma.A 16-year-old girl sought medical attention at the Mayo Clinic because of a 4.5-kg weight loss, hypercalcemia, and a pelvic mass. Preoperatively, the level of the beta-subunit of human chorionic gonadotropin was 147 IU/liter. After a brief period for observation and hydration, abdominal exploration revealed a stage III dysgerminoma; total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Within the dysgerminoma, syncytial giant cells expressed human chorionic gonadotropin-positive immunostaining in the cytoplasm. Postoperatively, the value of the beta-subunit of human chorionic gonadotropin decreased rapidly. The patient received whole-abdomen irradiation 4 weeks postoperatively, after which the level of calcium returned to normal. The patient has been free of disease for more than 7 years.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/19. seminoma with syncytiotrophoblastic giant cells. A special form of seminoma.Testicular seminomas may occur in various forms, of which the classical and spermatocytic are distinct, the anaplastic or atypical seminomas, however, less clearly defined. Lately, a separate group of particular clinical significance, comprising seminomas with syncytiotrophoblastic giant cells (STGC), has been specified. Although this type of seminoma had been recognized morphologically long ago, recent investigations have shown its ability to secret HCG, a fact that raises serious difficulties in its differential diagnosis with combined seminomas and choriocarcinomas. Two cases of seminomas with STGC are presented and pertinent clinical and morphologic problems discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
3/19. Familial dysgerminoma associated with 46, XX pure gonadal dysgenesis.Although the occurrence of pure gonadal dysgenesis PGD is usually sporadic and nonfamilial, here we present 3 sisters with 46, XX PGD, who are born from a first cousin marriage. review of their family pedigree is compatible with autosomal recessive inheritance. Surprisingly, 2 of these sisters developed ovarian tumors. Both showed the pathological result of dysgerminoma with syncytiotrophoblastic giant cells. These 2 cases are examples of tumorigenesis in PGD without an identifiable y chromosome. Therefore, malignant degeneration of the streak gonads should be considered in the patients with 46, XX PGD.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/19. Extragonadal sacrococcygeal seminoma--a case report.We report herein, a rare case of a 32 year old man who presented with a massive sacrococcygeal tumor found by digital examination. A transrectal biopsy was performed, however, as massive anal bleeding occurred 1 day later, an abdominal perineal resection was carried out. Histologic examination subsequently revealed the giant tumor to be pure seminoma. Residual masses of seminoma were detected by CT examination 1 month postoperatively and, despite irradiation, the patient died 26 months after the operation. Although there have been reports of extragonadal seminoma being located in the retroperitoneum, mediastinum and pineal body, this is the first reported case of it being found in the sacrococcygeal region.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/19. Ovarian dysgerminoma: immunocytochemical localization of human chorionic gonadotropin in the germinoma cell cytoplasm.A case of a pure ovarian dysgerminoma is reported in which the tumor was devoid of syncytiotrophoblastic giant cells, yet it produced human chorionic gonadotropin (hCG). Immunocytochemical studies localized the hCG in the germinoma cell cytoplasm, suggesting that these cells were the site of production.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/19. Human chorionic gonadotropin and alpha-fetoprotein in sera and tumor cells of a patient with pure dysgerminoma of the ovary. A case report with radio-immunoassay and immunoperoxidase.One of 7 patients with pure dysgerminoma had slightly elevated serum human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) levels as determined by radio-immunoassay before operation. The values returned to the normal range after the removal of the tumor. The cells that produced the HCG or AFP were identified by immunohistochemical staining of the tumor tissues. HCG proved positive both in the multinucleated giant cells with eosinophilic cytoplasm and in the spindle-shaped cells with a hyperchromatic nucleus. AFP was positively stained in the round cells. These results suggest that HCG and AFP are produced by the cells which constitute pure dysgerminoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/19. Post-irradiation lesions of the caudal roots.The article reports on 3 patients suffering from muscular atrophy after radiotherapy of the para-aortal lymph nodes for malignant testicular tumor without any sensory, bladder, or bowel disturbances. By neurophysiological examination, a lesion of the lumbal plexus and the peripheral nerves of the lower extremities were excluded. On EMG-examination there were no giant motor unit potentials, as they can be found in anterior horn cell lesions. Though there were no sensory deficits, a distinct prolongation of latencies and reduction of amplitudes could be found for lumbar dermatomal somatosensory evoked potentials (SSEP) and those after stimulation of some peripheral nerves of the lower extremities.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/19. Pure dysgerminoma of the ovary with elevated serum human chorionic gonadotropin: diagnostic and therapeutic considerations.Pure ovarian dysgerminomas with associated elevation of human chorionic gonadotropin (hCG) are rare, and their optimum management is unclear. We report here a 24-year-old woman with stage III dysgerminoma of the ovaries, with bulky intrapelvic disease, paraaortic adenopathy, and elevated pre- and postsurgical serum beta-hCG titers. Following administration of whole abdominal-pelvic and mediastinal irradiation therapy, the patient's adenopathy regressed, her serial beta-hCG titers returned to normal, and she has remained free of disease for the past 30 months. Histopathological studies revealed a pure dysgerminoma with scattered giant cells which were negative for hCG by immunoperoxidase staining. The literature is reviewed with reference to the significance of elevated hCG levels, the presence of giant cells in association with dysgerminoma of the ovary, and therapeutic implications. Serial determinations of beta-hCG titers may prove to be as valuable in the management of these patients as they are in patients with testicular tumors.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
9/19. seminoma with elevated human chorionic gonadotropin. The case for retroperitoneal lymph node dissection.An elevated serum level of human chorionic gonadotropin (HCG) in a patient whose primary tumor histologically appears to be a pure seminoma implies the presence of syncytiotrophoblastic giant cells either detectable by careful step sectioning of the primary tumor or present in metastatic disease. Inasmuch as the malignant potential and radioresponsiveness of syncytiotrophoblastic giant cells are unknown and the serum elevation of HCG may signal metastatic embryonal carcinoma, retroperitoneal lymph node dissection with adjuvant chemotherapy dependent on pathologic staging should be considered for patients with seminoma and postorchiectomy elevated HCG levels. An illustrative case is herein reported.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
10/19. Giant seminoma of undescended testis in down syndrome.A giant seminoma of undescended testis in a forty-one-year-old Japanese male with down syndrome is reported as is a review of the literature. The relationship between down syndrome and testicular cancer are discussed. To our knowledge this is the largest seminoma of undescended testis (weight 3,500 Gm) so far recorded.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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